摘要:
Electrodes for tissue stimulation and sensing can comprise a support with nanostructures disposed on the support. Pairs of the electrodes can be placed in close proximity to one another. When electrical energy is supplied to the electrodes, an electrical field (and possibly an electrical current) can be established between the nanostructures on the electrodes. The nanostructures may have cells disposed thereon, for example myocardial cells, myocardial progenitor cells, neural cells and/or stem cells. In addition, the electrodes can be arranged in arrays.
摘要:
A method and device for treating myocardial ischemia are described in which the stress experienced by a myocardial region identified as vulnerable to becoming ischemic is varied with pre-excitation pacing. In an unloading mode, pacing is applied in proximity to the vulnerable region to reduce stress and the metabolic demand of the region. In a loading mode, pacing is applied to a region remote from the vulnerable region in order to produce a conditioning effect.
摘要:
A cardiac rhythm management device for in which pre-excitation pacing is applied to one or more sites in proximity to an infarcted region of the ventricular myocardium. Such pacing servers to either prevent or minimize post-infarct remodeling.
摘要:
Electrodes for tissue stimulation and sensing can comprise a support with nanostructures disposed on the support. Pairs of the electrodes can be placed in close proximity to one another. When electrical energy is supplied to the electrodes, an electrical field (and possibly an electrical current) can be established between the nanostructures on the electrodes. The nanostructures may have cells disposed thereon, for example myocardial cells, myocardial progenitor cells, neural cells and/or stem cells. In addition, the electrodes can be arranged in arrays.
摘要:
Described herein are methods and systems for delivering pacing therapy to HF patients who do not exhibit a reduced EF. Such patients do not have systolic dysfunction and generally do not benefit from established HF therapies that either augment contractile function or counteract conduction abnormalities. In one embodiment, a HF patient with a normal EF is tested for the adequacy of heart rate response during exercise. If the patient is found to be chronotropically incompetent, a rate-adaptive pacing mode is employed in order to improve functional capacity.
摘要:
Methods and devices are described for delivering electrical stimulation to the heart in a manner that advantageously redistributes myocardial stress during systole for therapeutic purposes in the treatment of, for example, post-MI and HF patients. Pre-excitation pacing may be applied to deliberately de-stress a particular myocardial region that may be expected to undergo deleterious remodeling, such as the area around a myocardial infarct or a hypertrophying region or to deliberately stress a region remote from the pre-excitation pacing site in order to exert a cardioprotective conditioning effect, similar to the beneficial effects of exercise. Pre-excitation pacing may be advantageously combined with inotropic electrical stimulation applied to the stressed region.
摘要:
A method and device for delivering pre-excitation pacing to prevent or reduce cardiac remodeling following a myocardial infarction is described. The pre-excitation pacing is modulated in accordance with an assessment of cardiac function in order to balance the beneficial effects of stress reduction with hemodynamic compromise.
摘要:
A method of optimizing inter-site delay is disclosed for a cardiac rhythm management device that includes a dual chamber pacemaker, especially designed for treating congestive heart failure by pacing a plurality of sites. A microcontroller is operative to adjust the pacing mode and inter-site delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode inter-site delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Performance is optimized when the patient is at rest and when the patient exercises so that a rate-adapted dynamic value of the optimum performance can be applied.
摘要:
A sensing system including a collection catheter and a sensing device. The sensing system can be used in determining an optimal location of a collection catheter for the removal of a medium from coronary circulation. The sensing system can also be used in determining the optimal time for the collection of blood containing a medium. The sensing system can further be used to maintain a baseline flow rate through at least a portion of the coronary circulation system during a medical procedure.
摘要:
A biologic agent delivery system provides for delivery of a biologic agent to a stimulation site to which electrical stimulation pulses are to be delivered from an electrical stimulation device. Examples of the electrical stimulation device include cardiac pacemakers and neural stimulators. The biologic agent modifies tissue property to lower the stimulation threshold of the stimulation site. The genetic modification of the tissue property improves efficacy and/or energy efficiency of an electrical stimulation therapy.